title: A pig model for blunt chest trauma: no pulmonary edema in the early phase.
abstract: OBJECTIVE
  Chest trauma remains a leading cause of trauma-death. Since lung contusion is one of the most important lesions implicated, the aim of this experimental study was to evaluate the cardiorespiratory consequences of an isolated lung contusion model.
  
  
  METHODS
  Twenty-eight anesthetized pigs were studied during four hours. We induced a right lung contusion with five bolt shots (70 joules each) using a 22-caliber charge in twenty of them. Eight others pigs constituted the control group. The trauma consequences were assessed by histology, measurements of arterial oxygenation, plasma cytokines, pressure-volume mechanics, hemodynamic monitoring using the PiCCO system and a pulmonary artery catheter. The extra-vascular lung water was measured using the gravimetric method.
  
  
  RESULTS
  Histology confirmed an isolated right lung contusion without cardiac injury. Compared to baseline values, the trauma group was characterized by a decrease in cardiac index (3.3 ± 0.8 vs 3.9 ± 1.2 l/min/m(2); P < .05) and mean arterial pressure (80 ± 21 vs 95 ± 16 mmHg; P < .05) without preload or afterload modification. Oxygenation (PaO2/FiO2: 349 ± 87 vs 440 ± 75; P < .05) and static compliance (26.3 ± 7.4 vs 30.3 ± 7.8 ml/cmH2O; P < .05) were also impaired during two hours compared to baseline. No edema was noticed in either group whatever the lung considered. All measured cytokines were below the detection threshold.
  
  
  CONCLUSIONS
  An isolated right lung contusion is associated with rapid but transient cardiorespiratory impairments. Despite the large extent of the lung contusion, no pulmonary edema appeared during the period studied.
authors.affiliation: Réanimation des Urgences et Médicale, Hôpital de la Timone, Université de la Méditerranée, 13005 Marseille, France. david.couret@ap-hm.fr
authors.forename: David
authors.initials: D
authors.lastname: Couret
authors.forename: Sophie
authors.initials: S
authors.lastname: de Bourmont
authors.forename: Nicolas
authors.initials: N
authors.lastname: Prat
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Cordier
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Soureau
authors.forename: Dominique
authors.initials: D
authors.lastname: Lambert
authors.forename: Bertrand
authors.initials: B
authors.lastname: Prunet
authors.forename: Pierre
authors.initials: P
authors.lastname: Michelet
mesh_terms: D000818:Animals; D003288:Contusions / Q000150:complications / Q000473:pathology; D016207:Cytokines / Q000097:blood; D004195:Disease Models, Animal; D005260:Female; D006439:Hemodynamics; D008168:Lung / Q000473:pathology; D055370:Lung Injury / Q000150:complications / Q000473:pathology; D011654:Pulmonary Edema / Q000209:etiology* / Q000473:pathology; D013552:Swine; D013898:Thoracic Injuries / Q000150:complications* / Q000473:pathology; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000473:pathology
chemical_list: D016207:Cytokines